doc fix

Ryan greets Obama as he arrives to deliver his final State of the Union address while Vice President Joseph R. Biden Jr. looks on. It was one of Ryan's few smiles of the evening. (Bill Clark/CQ Roll Call)

President Barack Obama repeatedly had to raise his voice to be heard over cheering Democratic lawmakers during his State of the Union address on Jan. 12. But Speaker Paul D. Ryan sat motionless, his face frozen in a polite — but unimpressed — expression.

Obama used part of his likely final address to a joint session of Congress to extol policy whims long pushed by Democrats like pre-kindergarten “for all” children and a government-led effort to “to make college affordable for every American.” He also called it a “basic fact” that the U.S. “has the strongest, most durable economy in the world,” saying the country is “in the middle of the longest streak of private-sector job creation in history.”

The Senate is facing a post-recess time crunch on the 'doc fix.' (Tom Williams/CQ Roll Call File Photo)

Lawmakers will already be facing a time crunch when the Senate returns Monday.

The Centers for Medicare and Medicaid Services has been withholding payments to doctors treating Medicare patients to give Congress a window to work through a long-term resolution to the Sustainable Growth Rate problem that sees physicians regularly facing draconian cuts in payment rates without a patch known as a "doc fix."

While it was pushing for a "doc fix" to delay cuts in Medicare payments to physicians, the PAC of orthopaedic surgeons contributed over $360,000 to Congressional candidates, leadership PACs, and party committees during the first quarter of the year.

The PAC of the American Association of Orthopaedic Surgeons contributed $361,650 to federal candidates during the first quarter. Orthopaedic surgeons deal with conditions involving the musculoskeletal system. The surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Several Senate Republicans who backed a procedural motion to allow the measure known as the "doc fix" to get a final vote opposed the legislation — the very same day. The final vote on the bill, Congress' 16th "doc fix" patch , was 64-35 . It passed thanks to Republican moderates and party leadership on both sides.

In a cost estimate released Monday, the Congressional Budget Office explained that $601 billion in projected savings from limits on the Overseas Contingency Operations account might never be spent anyway, and noted there's no funding currently provided for the OCO funding.

The House on Thursday passed a bill that likely did not have the votes to pass.

It was clear that a bill to avert a pay hike for doctors was short on support, so Republican leaders struck a closed-door agreement with Democrats to pass the bill by voice vote while members were not yet in the chamber, according to members and aides from both parties.

Updated 6:18 p.m. | Senate Majority Leader Harry Reid hoped to send a yearlong patch for payments to doctors treating Medicare patients to President Barack Obama's desk today, but it was not to be. A vote on the "doc fix" bill was postponed until Monday evening.

The Nevada Democrat's comments on the floor backing the patch came not long after a surprise House voice vote to pass the measure, which represents a compromise between Reid and Speaker John A. Boehner, R-Ohio.